Eczema during pregnancy is common and treatable, with most options considered safe for both you and your baby. The condition tends to appear in the first or second trimester, driven by immune shifts that come with carrying a pregnancy. About 1 in 5 pregnant people with skin conditions are dealing with some form of atopic eruption, which includes eczema, prurigo of pregnancy, and pruritic folliculitis. The good news: a clear treatment ladder exists, starting with gentle daily habits and moving up to prescription options when needed.
Why Eczema Flares During Pregnancy
Your immune system changes significantly during pregnancy to protect the developing fetus. In the second trimester, rising levels of progesterone and estrogen push your immune system toward a pattern that favors allergic-type responses, which is exactly the kind of immune activity behind eczema. This is why many people experience their first eczema flare ever during pregnancy, or see a condition they thought they’d outgrown come roaring back.
Later in the third trimester, the immune balance shifts again as your body prepares for delivery. Some people find their eczema improves at this point, while others don’t get relief until after birth. Either way, knowing that these flares are tied to temporary hormonal changes can be reassuring: pregnancy eczema usually resolves postpartum.
Start With Daily Moisturizing
Consistent moisturizing is the foundation of eczema management during pregnancy, and it’s the one step with zero safety concerns. A thick, fragrance-free moisturizer applied at least twice a day (and immediately after bathing) helps repair your skin barrier and reduces how often you need medicated treatments. Look for products free of fragrances, alcohols, and sulfates, all of which can trigger or worsen flares.
Ceramide-based creams and plain petroleum jelly are reliable choices. Ointments tend to lock in more moisture than lotions, though they feel greasier. If your skin is already cracked or weeping, ointments are worth the tradeoff. Keeping showers short and lukewarm also helps, since hot water strips oils from already-compromised skin.
Topical Steroids: The Main Prescription Option
When moisturizing alone isn’t enough, topical corticosteroids are the standard next step. Mild to moderate potency formulations are permitted during pregnancy and remain the most commonly prescribed treatment for flares. You may need to use them on specific areas and in smaller amounts than you would outside of pregnancy, but they’re well-established as safe when used this way.
The key is using the lowest effective strength for the shortest time needed to get a flare under control. Your provider will typically recommend applying a thin layer to active patches for one to two weeks, then tapering off. Higher-potency steroids are generally reserved for stubborn areas like the palms or soles, and only under close supervision. Long-term, continuous use of potent topical steroids on large body areas is what raises concern, not short, targeted courses on smaller patches.
Calcineurin Inhibitors as an Alternative
If you prefer to limit steroid use, or if your eczema is in sensitive areas like the face, eyelids, or skin folds, topical calcineurin inhibitors are another option. These non-steroidal creams work by dialing down the overactive immune response in the skin without the thinning effect that steroids can cause over time. Current dermatology guidelines consider intermittent use of these topicals acceptable during pregnancy.
They can sting or burn slightly when first applied to inflamed skin, but this usually fades within a few days of regular use. They’re particularly useful for maintenance between flares on areas where you’d rather not repeatedly apply steroids.
Light Therapy for Widespread Eczema
For eczema that covers large areas of your body or doesn’t respond well to creams alone, narrowband UVB phototherapy is a safe and effective option during pregnancy. Sessions involve standing in a light booth for a short time, typically two to three times per week, for 8 to 12 weeks.
One consideration: higher cumulative doses of UVB light may lower folate levels, particularly in people with lighter skin. Since folate is critical for preventing neural tube defects, your provider may monitor your levels or recommend additional folic acid supplementation if you’re doing frequent sessions. For people with darker skin tones, this folate effect appears to be less of a concern, though supplementation is still standard practice during pregnancy regardless.
Oral and Injectable Treatments for Severe Cases
Most pregnant people can manage eczema with the options above. But if your eczema is severe enough to disrupt sleep, cause widespread skin breakdown, or resist topical treatments entirely, stronger options exist.
Oral corticosteroids (steroid pills) may be prescribed for short periods when other treatments fail. These are not first-line and come with more considerations than topical versions, but a brief course can break a severe flare cycle when nothing else is working.
For people already on biologic injections before becoming pregnant, the question of whether to continue is increasingly studied. A recent meta-analysis pooling data from 115 pregnant women found no increase in congenital malformations compared to the general population, and the rate of miscarriage (about 19%) fell within the normal background range of 11 to 22%. These numbers are reassuring, though the evidence base is still relatively small. The decision to continue, pause, or stop a biologic during pregnancy is highly individual and depends on how severe your eczema is without it.
Reducing Flares Without Medication
Beyond prescription treatments, a few practical habits can meaningfully reduce how often and how badly you flare:
- Wear loose, breathable fabrics. Cotton and bamboo are less likely to irritate than wool or synthetic materials, especially as your body temperature runs warmer during pregnancy.
- Keep your home humidity between 40 and 60%. Dry air worsens eczema, and a simple humidifier in your bedroom can make a noticeable difference, particularly in winter.
- Manage stress where you can. Stress is one of the most consistent eczema triggers, and pregnancy brings plenty of it. Even basic practices like consistent sleep and gentle movement help regulate the stress hormones that drive flares.
- Avoid known personal triggers. If you already know that certain soaps, detergents, or foods worsen your skin, pregnancy is not the time to test your tolerance. Stick with what works.
What to Expect After Delivery
The immune shifts that triggered your eczema during pregnancy reverse relatively quickly after birth. Many people see significant improvement within weeks of delivery. If you’re breastfeeding, some treatments that were off-limits during pregnancy may still need to wait, but your options generally expand. For people who experienced eczema for the first time during pregnancy, there’s a reasonable chance it won’t return, though some develop a chronic pattern that persists. Either way, the full range of eczema treatments becomes available again once you’re no longer pregnant or nursing.